Silicon Valley could see a coronavirus-related death toll of 2,000 to 16,000 at the end of May, depending on how seriously people take the order to stay home as much as possible, according to forecasts presented at a San Jose City Council meeting Wednesday.
The thinking behind the rough estimates illustrates why health and elected officials throughout California have heard the alarm about the exponential increase in cases of coronavirus reported since early March. Los Angeles Mayor Eric Garcetti to San Francisco’s Director of Public Health, Dr. Grant Colfax, has warned of a sharp increase in seriously ill coronavirus patients needing hospitalization over the next week or two.
“Even at best, we looked at the order – over the next 12 weeks – of 2,000 potential deaths directly from COVID-19,” San Jose Deputy City Manager Kip Harkness said of an appreciation of the estimated deaths for Santa Clara County, California’s sixth most populous county.
Harkness emphasized that the forecasts he presented are coarse and the county is working on a more detailed and robust estimate. “But given the urgency of the situation, we have decided to share [these] preliminary results with you and the public today, to derive the measures needed to save lives, Harkness said.
If nothing was done, the death from the virus that could cause serious respiratory problems affected 16,000 people for this county of nearly 2 million people, with only one fifth of the population of Los Angeles County.
But if there is a mediocre compliance with the protected site order issued across the San Francisco Bay Area on March 16, which was followed by a similar government order issued three days later – where “we do something, but [it’s] not well lived ”- There may still be a much worse death rate than the best case, with nearly 8,000 dead in Santa Clara County.
“It’s the hardest picture to look at,” said Harkness, who focuses on readiness for California’s third most populous city.
Why coronavirus cases are still increasing despite order in place
Cases of coronavirus are still increasing in Santa Clara County, despite the sweeping on-site protection system issued over the San Francisco Bay area a little more than a week ago, as the infection cases now identified represent infections that occurred one more two weeks ago. told Dr. Sara Cody, Santa Clara County Public Health Ombudsman, to the county administrative board at a meeting Tuesday.
“The cases we identify now still reflect the transmission and what happened in our society one to two weeks ago, so that’s the delay,” Cody said.
It can take two to 14 days after someone has been infected with coronavirus before showing the symptoms of the disease known as COVID-19.
But it can take even longer to get seriously ill. Here is the median time it took from the first signs of illness to the following results, according to a study of patients in Wuhan, China:
- From beginning of illness to shortness of breath: 7 days
- From the onset of the disease to sepsis: 9 days
- From the onset of the disease to acute respiratory distress: 12 days
- From the beginning of illness to intensive care: 12 days
- From the beginning of the illness to death or hospital discharge: 21 days
That kind of timeline has also been seen in California.
The symptoms may appear relatively mild during the first week, with the main symptom being a cough, and the patient is treated as an outpatient.
It is only during the second week that patients rapidly deteriorate, and in a few hours they cannot breathe on their own and suddenly need a breathing tube inserted into their throat so that they can be connected to a mechanical ventilator that drives oxygen into the lungs, according to an interview as Dr. Stephen Parodi, a Kaiser vice president and physician for infectious diseases, gave to the Journal of the American Medical Assn.
The next few weeks are critical
Officials also say that the number of cases of coronavirus in Santa Clara County is much larger than currently documented. As of Wednesday evening, Santa Clara County reported 459 coronavirus cases and 17 deaths. But Harkness, a San Jose official, said there are probably 9,000 to 19,000 people in Santa Clara County with the coronavirus infection.
“The current number of … positive tests vastly underestimates the number of actual cases,” Harkness said. “That means we have a false sense of security when it comes to thinking,” Oh, everyone tested is the only ones infected. “No, there are a large number of us walking around who are infected.”
So the next few weeks are critical. First, if virtually everyone adheres to the strict home-home orders set by the county and Prime Minister Gavin Newsom, it will “significantly bend the curve” of what would otherwise be an exponential increase in cases.
But the region still needs to find more intensive care beds and ventilators, Harkness said. Without them, the death rate for critically ill patients is doubled.
Can the growing demand for beds with intensive care be met?
In the worst case, if there had been no order for people to stay at home as much as possible to curb the outbreak, the demand for intensive care beds during the outbreak would vastly exceed supply many times, according to a picture presented by Harkness.
A so-so method, where many people do not follow the order of the home-home, can still leave the county with too few ICU beds.
But strict compliance with the home-home orders, combined with increasing the number of beds for the intensive care unit, could keep Silicon Valley close to meeting demand, Harkness said.
“The most important thing everyone can do is to follow the public health orders – protection in place. This is this strange moment where the biggest thing you can do to help is this: Do nothing. Go home. Stay on your couch. Watch some Netflix, Harkness said.
“I know it’s difficult, especially for those of us who think action is what we need to do,” he added. “But in this particular epidemic,” being “can be more important than” doing “for most of us.”
County racing to secure more fans
Santa Clara County has made efforts to increase its health care capacity. A 24-bed federal medical station is set up at the Santa Clara Convention Center to be used as a “medical respite unit” for coronavirus-infected patients who do not need to be hospitalized but cannot return home to care for themselves.
The county has ordered 211 mechanical fans and the state has promised to provide 100 more, Santa Clara County Executive Director Dr. Jeffrey V. Smith, who is also a physician and a lawyer, to the Supervisory Board on Tuesday. The county, which operates several hospitals, also seeks to employ more than 100 nurses.
Smith said the county tracks how many beds are available at the region’s hospitals related to COVID-19, especially in the intensive care unit. As of Tuesday, there are empty ICU beds and available fans, “but we are very, very, very concerned that when a couple of weeks have passed, we will really be challenged.”
Of the 375 Santa Clara County residents who were confirmed to have the coronavirus infection as of Monday night, their severity is still quite high. Cody, the health representative, said at the supervisory meeting Tuesday that 125 were hospitalized at the time of diagnosis, including 13 who were in the intensive care unit.
San Francisco executives said Wednesday that the city was likely to face a crisis similar to that of New York City and would soon be 1,500 fans and 5,000 hospital beds. “It’s not even a question of whether we will need more,” said San Francisco Mayor London Breed.
Coronavirus testing is still a change
Lab testing for coronavirus to confirm if a sick patient has the virus that causes COVID-19 is still a challenge for Santa Clara County. “Despite the federal government’s announcement, the test is not as widespread as we would like it to be, and as it should be,” Cody said Tuesday.
The local public health laboratory has been able to test for the virus since February 26, but just like other state and local public health laboratories, was never designed to function as commercial laboratories. So they don’t offer high-volume test capacity to process thousands of tests daily, Cody said, “that’s why we’re dependent on the commercial and academic sectors.”
Cody and other San Francisco Bay Area health officials on Tuesday issued a new order requiring laboratories to report to officials not only the positive coronavirus cases, but the negative ones as well. Länna had no clear idea of how much testing was taking place in the region as the negative results had not been reported to the local authorities.
“It will also allow us to understand if there are areas where there are higher levels of positivity where there can be more intensive transfer [of the virus] and of course it’s very important for us to understand when we try to reduce the transmission and bend the curve, “Cody said.
Epicenter of California’s coronavirus crisis
Santa Clara County has become the episode of California’s coronavirus crisis, with more deaths than any other county in the state.
The initial hint of trouble emerged when it became clear that among sick people being tested in Santa Clara County, the proportion of people who tested positive for the new coronavirus was significantly higher than in other communities, Smith said. It was an ominous sign that indicated that there was also a high proportion of people infected with the coronavirus who did not yet show signs of illness.
About 80% of infected people show mild or minimal symptoms of illness.
Smith said an earlier projection mentioned by Newsom that more than half of Californians could be infected with the corona virus over a two-month period was based on undisturbed spread of the virus and that it probably won’t occur.
But since Santa Clara has been at the forefront, we really have to be prepared and our focus has been to try to make sure our system is not overwhelmed, Smith said Tuesday.
Source -> https://www.latimes.com/california/story/2020-03-26/coronavirus-deaths-silicon-valley-santa-clara-county-pandemic-projection